The new england journal of medicine - PULSION Medical Systems SE

2220
A
B
Percentage of Baseline Measurement
Percentage of Baseline Measurement
11
10
9
8
7
6
5
4
3
2
1
0
12
11
10
9
8
7
6
5
4
3
2
1
0
ized trials of patients undergoing high-risk surgery,
31 patients with the acute respiratory distress
syndrome and sepsis, 32 those with congestive heart
failure, 34 and those with general critical illness 33,35
have reported no benefit from PAC insertion. How-
The new england journal of medicine
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Pulmonary-Artery–Occlusion Pressure (mm Hg)
1 2 3 4 5 6 7 8 9 1011121314151617181920212223242526272829303132
Central Venous Pressure (mm Hg)
Figure 3. Distribution of Pulmonary-Artery–Occlusion Pressure (Panel A) and Central Venous Pressure (Panel B)
before Receipt of the First Protocol-Mandated Instruction on Fluid Management.
A total of 29 percent of patients had a pulmonary-artery–occlusion pressure that exceeded the traditionally accepted
threshold of 18 mm Hg, though the majority of these pressures were 19 or 20 mm Hg, and 97 percent of patients with
an initial pulmonary-artery–occlusion pressure of more than 18 mm Hg had a normal or elevated cardiac index.
n engl j med 354;21 www.nejm.org may 25, 2006
ever, these studies were limited by the inclusion of
relatively small numbers of patients and the lack
of a strictly defined treatment protocol.
Prevention or reversal of organ failure is a
common justification to insert a PAC, but we
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